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NPI Code Detail

MEDICARE: EL DORADO TEXAS COMMUNITY SERVICE CENTER

MEDICARE: EL DORADO TEXAS COMMUNITY SERVICE CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
2261QM2800XMethadone Clinic30484TX

General Provider Information

NPI Number : 1003361262
Entity Type Code : Organization
Provider Name (Legal Business Name) : EL DORADO TEXAS COMMUNITY SERVICE CENTER
Provider Business Mailing Address
First Line : 954 E MADISON ST
Second Line :
City : BROWNSVILLE
State : TX
Zip : 78520-5950
Country : US
Telephone Number : 956-550-9970
Fax Number : 965-982-4294
Provider Business Practice Location Address
First Line : 954 E MADISON ST
Second Line :
City : BROWNSVILLE
State : TX
Zip : 78520-5950
Country : US
Telephone Number : 956-550-9970
Fax Number : 965-982-4294
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : CYNTHIA ANN BLANKS
Credential :
Telephone Number : 661-254-6630
Provider Enumeration Date : 08/17/2016
Last Update Date : 03/24/2026

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Directions to “EL DORADO TEXAS COMMUNITY SERVICE CENTER ” Practice Location

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